morning guys I'm Siobhan first year
medical resident and today is my first
day in the ICU oh my gosh man I'm
actually nervous on the logical side of
my brain I know that I'm super supported
and everyone knows it's my first day in
the ICU and they won't expect me to be
making decisions on my own but then
there's the emotional side over here and
that's the side that tells me but what
if something happened that I am on my
own or you know what if I look like I'm
dumb because I've never done ICU or I
don't know the answer to their questions
or I just don't know what's going on and
I think it's that fear of the unknown
that just sort of takes over sometimes
plus it's in the name it's called
intensive care unit so makes you think
it's probably gonna be an intense day oh
did I forget to mention that not only is
it my first day but it's gonna be my
first call shift so my first day will be
24 hours okay wish me luck
[Music]
so you may be thinking what is the ICU
so it's the intensive care unit and the
way I like to think about it is it's a
place where someone needs to be
monitored more closely they may need
interventions these patients are a lot
sicker
basically unlike what I normally do on
the wards this is very much a team sport
so the ICU is a circle and as a team we
go around from patient to patient one
person is gonna be on the computer
looking at the lab work the other person
is gonna be looking at the chart and
writing out the note for the day so
we're all working together and this
morning we actually had a new patient
that showed up in the ICU so this is the
patient comes in breathing fast like
like really fast like 40 breaths per
minute
normally we breathe like 12 to 16
breaths per minute that's fast to be
going at 14 years and it's like running
a marathon just like you'd get tired if
you were running a whole bunch you'll
get tired if you're breathing like that
for a long time if you were anywhere
else people would be really nervous you
know you'd be calling for help but here
in the ICU this is the help these are
the experts in this and it was so cool
to see everyone just come together know
exactly what's happening make a plan
organize themselves and just execute
that plan like perfectly it was so great
to see so guys I just had my first
procedure in ICU so I was putting an
arterial line so basically that's when
you're threading a catheter into
someone's artery in their wrist and the
whole purpose of that is so that we can
constantly know their blood pressure I'm
just pretty amazing like when you think
about it you normally go to the doctor
they blow up that cuff and then you know
your blood pressure but this will know
it all the time and so if there any
changes we'll know immediately
and that's really important in the ICU
so first thing was to get the ultrasound
machine and to figure out where the
actual artery is you don't have to use
one but since we have the opportunity
most people think it's just safer to use
it now and then after that have to pick
out all the supplies and that's sort of
the most time-consuming thing but this
hospital they have it so well organized
so this is what an arterial line looks
like first you cut
this needle and then this long thing is
a big guide wire the guide where it goes
in and then you slip over the catheter
which I'm not sure if you can really see
it here it's this plastic little bit and
end right here can you see that and then
all of this this part all stays hanging
outside on the person's arm and this
part here all the way to there ends up
staying inside their artery so pretty
cool it's not as scary as it looks
because that looks really long and big
so I'm really happy to say it went well
and it's sort of like a really nice way
to start start the night with a little
bit of confidence all right so the day
team just left and now I'm just gonna go
put my stuff in the call room I think
you guys are getting the tour of all the
different so just finished what they
call tuck in rounds and it's kind of a
cute name it's basically you go all the
way around the ICU again and just doing
it quickly to see if there any issues in
the evening that we can tidy up and I
gotta say it's just such a nice
environment here like everyone goes by
their first name people all know each
other they're so friendly it's just it's
a great environment oh and apparently
there are two consults or two people
that may need to come see ICU one of
them is up in the ward and apparently
they're doing really badly and so that
usually means they're coming to us and
the second one is a patient who has been
in the operating room for at least 12
hours and
I'm gonna need to come to the ICU
afterwards so we can help out with
fluids and giving blood and just keeping
a close eye on this person so that's
coming soon so I'm gonna relax for a bit
so it's 1 a.m. now I just admitted one
patient and I ended up just doing a
walk-around of the ICU just to see if
there were any issues and they're always
so many snacks at the nursing station so
I kind of grabbed some gummi bears on
the way back anyway so now I'm going to
go to sleep and let's see what happens
there was one more patient on the ward
that may come down so we'll see alright
so one more patient admitted this one
was the patient with an overdose and so
now I'm just gonna do another quick
round see if any of the nurses have any
issues and then I think I'm gonna grab
myself a hot blanket and then head back
to the call room so it's 8:30 a.m. just
hand it over just finished first day of
ICU the summary is not as bad as I
thought feeling super supported still
feeling a bit overwhelmed in terms of
the amount of knowledge that I still
need to acquire so I'm definitely
feeling motivated to study but first
definitely time for a nap so let me know
if you have any questions about the ICU
or things you want me to cover in the
next couple of months while I'm on this
rotation and otherwise I will chat you
guys soon so bye for now
you